As your patients leave Phase 2, Ongoing Weight Loss (OWL), and move on to Phase 3, Pre-Maintenance, it’s natural for them to feel conflicted. They’re impatient to reach their goal, but it’s important for them to understand that slow and steady weight loss is the correct path to permanent weight control. If they follow these 10 guidelines their transition to Pre-Maintenance should be smooth sailing.
1. Continue to count. Your patients may feel like old Atkins hands after several months on the program, but as they home in on their goal weight, it’s all the more important that they continue to track their Net Carb intake. Only that way can they understand their specific tolerance for carbs as they gradually increase the amount and variety of carbohydrate foods they’re eating.
2. Eat those veggies. They should continue to include at least 12–15 grams of foundation vegetables in their daily carb count. Although they may be able to add starchy vegetables in this phase, they should regard them as incremental, not as a substitute for the salad greens and other low-carb, high-fiber veggies they’ve been eating all along.
3. Climb the carb ladder carefully. Following the Carb Ladder gradually increases the range of foods, but should not change the amount of food consumed.
4. Introduce one new food at a time. As they return to the world of apples, acorn squash and brown rice, caution your patients to gauge the impact of each food before moving on to the next.
5. Stick to two portions of fruit a day. The sugar in fruit is natural, but that doesn’t mean it should be overdone. If they have half an apple, for example, they should eat only one serving of berries that day.
6. Don’t overdo protein. As more carbohydrate foods are added, it may be necessary to reduce protein intake slightly if your patient was at the top of the intake range for his or her gender and height.
7. Drink up. For both general hydration and to help keep hunger at bay, it’s important to continue to drink eight glasses of water and other acceptable liquids each day.
8. Watch for fat hunger. As a person approaches his goal weight, the body burns less of its own fat and relies more on dietary fat. That may necessitate adding some slices of avocado to a salad, more olive oil to vegetables or another dollop of whipped cream to berries.
9. Eat regularly. Advise your patients once more not to go for more than four to six hours between meals or a meal and a snack; and stop eating the moment they feel they’ve had enough.
10. Advance cautiously. Now that they’re increasing their daily carb intake in 10-gram increments every week or several weeks, your patients should be on the alert for weight regain or the return of symptoms such as excessive hunger or carb cravings.